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Too much ‘D’




 

 

DEAR DR. ROACH: I am an 86-year-old woman with three doctors battling over my vitamin D level for many years. I am 59 inches tall and weigh 95 pounds. I play nine holes of golf three times a week. I have always been a poor eater, so I get little nourishment from food. I drink 3 ounces of scotch every evening with chips. That’s my nourishment.

I’ve beaten lung cancer and recently had skin cancer surgery in my ear. The vitamin D situation never goes away, and the doctors keep changing my meds. One of the doctors claims that my vitamin D count is almost toxic (my blood levels of vitamin D are 121 from my rheumatologist and 145 from my internist), and I have been taken off any meds with vitamin D in them, but it’s still high.

I am feeling OK now and want to forget the whole matter of the vitamin D level. — Anon.

ANSWER: I have seen only one case of vitamin D excess in my career. It is very rare if people are taking less than 4,000 IU of vitamin D daily, so I suspect you were taking much higher doses at some point. When I hear that multiple doctors may have been taking care of you, I worry that more than one was prescribing high doses of vitamin D. There also have been cases of manufacturing errors and excess fortification of milk, but these are quite rare.

Vitamin D is normally stored in the liver, with the fat cells becoming a second reservoir. The toxicity of vitamin D is due to high calcium levels, which can cause confusion, nausea and vomiting, and muscle weakness. Toxic levels can be treated with short-term prednisone, but that isn’t necessary unless there are symptoms or a dangerously high calcium level.

By the time your letter is published, your vitamin D levels should have returned to normal. If they haven’t, it’s time to look for a rare cause, such as sarcoidosis, where occasionally the abnormal cells can make vitamin D.

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DEAR DR. ROACH: My mother was diagnosed a few years ago with macular degeneration (both wet and dry). Is this disease hereditary? What can I do to prevent myself from getting this disease? — K.

ANSWER: There does seem to be an increased risk in people with a family history. Several studies have shown that vitamins, especially B vitamins, can reduce risk by a third or so. Since a combination of zinc and vitamins A, C and E was shown to help reduce progression of macular degeneration, many experts recommend it for prevention as well.


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